Spotlight on Rotator Cuff Injuries

Each year, approximately 4.2 million people are diagnosed with shoulder and upper arm injuries in the United States. Most injuries are not from broken bones as you might think. Injuries of the muscles and tendons of the rotator cuff are much more common. Rotator cuff injuries happen to athletes, especially pitchers, swimmers and tennis players. People who deliver mail, carry newspapers, paint, garden and hang curtains can also suffer from rotator cuff injuries. The elderly are especially prone and sometimes the injury comes from very insignificant trauma or light lifting.

Screwing in a light bulb, lifting a plate off a top shelf or throwing a ball shouldn't hurt. All these actions involve reaching above the head and are usually taken for granted - as long as your rotator cuff is working OK.

What is the rotator cuff?

The rotator cuff is a group of tendons and muscles that stabilize the shoulder joint, allowing you to raise and rotate your arm. The shoulder joint is a ball and socket with three main bones: the clavicle (collarbone), the humerus (upper arm bone) and the scapula (shoulder blade). Muscles, tendons, ligaments and the joint capsule hold these bones together. The shoulder joint is capable of a huge range of motion. However, it is also vulnerable to injury that results in pain, weakness and even joint dislocation. The good news is that rotator cuff injuries are treatable.

Types of injuries

Sudden: Lifting a heavy object, falling or making a sudden, powerful motion can result in a sudden injury. For instance, a single 90 mph fastball or one winning overhead tennis shot may be all it takes to tear a rotator cuff muscle - causing sudden, intense pain.

Gradual: Injury can happen gradually, as a result of repetitive use. Any kind of activity that involves repeated overhead arm movements or repetitive lifting carries the risk for rotator cuff injury.

Symptoms of rotator cuff injuries

The following symptoms may occur with gradual injuries:

• Pain when lifting the arm forward, above the head.
• Pain that is worse at night.
• Pain that eventually is accompanied by weakness, with increasing difficulty moving the arm at all, especially out to the side.

Symptoms of acute injury can include:

• Sudden severe pain (or a tearing feeling) in the shoulder, followed by pain down the entire arm.
• Very limited use of the involved arm.
• Pain that continues when the arm is at rest.

When to seek medical attention

• If the pain lasts more than 2 days.
• If you are unable to carry out your usual tasks.
• If you have arm weakness, numbness or tingling (a "pins and needles" feeling).

A note on treatment

Minor inflammation of a rotator cuff muscle tendon usually goes away completely. Pain and inflammation are treated with oral medications called nonsteroid anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen, and ibuprofen. However, NSAIDs are not safe for everyone, including those with liver, kidney, heart disease, stomach problems and other conditions. Talk to your doctor before taking NSAIDs.

Narcotic pain medicine may be necessary for severe pain. A steroid injection into the shoulder joint is also used for acute pain. A partial or complete tear of a rotator cuff tendon may require surgery so the shoulder can function properly again.

Source:

American Academy of Orthopedic Surgeons.

This article was reviewed and updated June 2007.